Outtakes, Part 10: A Light Tale from the Dark Side

This was one of the very first stories I wrote after graduate school. If there’s any truth to the notion that writing is a skill that takes years to master, the following anecdote is a great piece of evidence. It’s terrible. However, I include it here, along with the other Outtakes, because I did say this section of the site was to show how writers grow over time. Also, some of my friends thought my awkward experience at Banana Republic was amusing.

If you haven’t read ‘Crazy’ but are considering it, rest assured that this piece is much, much worse than the book. If you have read it, note the contrast between how guarded I am here versus the finished product.

I met Jim during the early days of my internship. He had entered the clinic ten months after his girlfriend had ended their relationship. At first, Jim didn’t think there was anything especially wrong with him. One day, however, his parents pointed out that he was talking much more than usual, seemingly responding to a voice no one else could hear. It turned out to be two or three voices, male and female, sometimes overlapping, like a radio show that never went off the air.

If the growing din between his ears was bothering Jim, he didn’t show it. He didn’t seem sad or even anxious about the voices that kept nagging him. Like many people with Schizophrenia, he appeared to be emotionally flat, almost expressionless. He would use the same monotone voice to say, “I thought about whacking my mother with an axe this morning” as he would to say, “Rob Dobrenski is quite the snappy dresser, is he not?”

For the first few weeks, Jim provided me with an inside look at what he was going through. Each of the voices nesting inside him was continually supplying negative commentary:

“You suck, you always have.”
“She left you for a reason, you’re a loser!”
“You’re no good in bed.”
“You bored her to death. She never liked you from the beginning.”
“Watch what you say, Jim, she can hear you!”

I immediately submitted a medication evaluation request on Jim’s behalf but the results were not quite what I had hoped:

Jim: He told me that I have Schizophrenia.

Dr. Dobrenski: Yes. And, as we have discussed and we have both agreed, you do have Schizophrenia.

Jim: I know. But you told me that after we talked for a few sessions and you got to know me. He talked to me for only twenty minutes and the next thing I know he’s made his diagnosis and is trying to give me Haldol. I nearly smashed his face.

This is one of the biggest criticisms of psychiatry: lack of face time. While most psychiatrists are empathic people, they do earn their living through the prescription pad.

Dr. Dobrenski: Did you tell him about your fears of persecution?

Jim: Yes, I did just as you told me.

Dr. Dobrenski: I believe Haldol is something that can help eliminate those fears.

Jim: Well, I just didn’t like the way he phrased it.

Dr. Dobrenski: Jim, we talked about this. If the doctor recommended medication, you should strongly consider taking it. It’s part of the treatment. I don’t really know of anyone who has your difficulties who hasn’t needed some help in controlling all those horrible thoughts you describe, at least on a temporary basis.

Jim: I get help. That’s what I have you for.

Dr. Dobrenski: Jim, what does it mean to you to have to take medicine?

Jim: It means…I don’t know. It means I’m crazy I guess.

Dr. Dobrenski: Do you see how that view is leading to your distress?

Jim: Yes.

Dr. Dobrenski: Jim, there’s another way to look at this. Taking medicine does not mean you’re “crazy.” It means you have an illness, a mental illness. It needs to be treated. If you had diabetes, you’d need insulin. That wouldn’t qualify you as crazy, so why would this?

Jim: I don’t know, it just feels different.

Dr. Dobrenski: I hear you, I think I really hear you, but that doesn’t mean that it’s true. It’s a myth that people should have complete and total control of everything their brain does. It’s an organ, like a kidney or liver. It doesn’t always do what you want it to do. To me, “crazy” would be you knowing that you need help and refusing to get it.

Jim eventually agreed to accept medication while resisting any urges to attack. And, fortunately, it worked quite well. Is it likely that Jim will require treatment for the rest of his life? Absolutely. But he is already much improved. Medication has minimized his hallucinations and he’s able to function at work. Perhaps even more importantly, we made a connection, one that has allowed him access to the resources he needs to relieve his symptoms. In fact, this connection led to a question that was very important to him.

Jim: Rob, have you ever been on medication?

Dr. Dobrenski: You mean like antibiotics? Sure.

Jim: No, “mental health” medicines.

If I were a smoker, I’d probably have stubbed out a cigarette at that moment, the way so many people in the movies do when they’re about to say something poignant.

Dr. Dobrenski: Jim, I’m going to answer your question straight up, because I told you when we first met that I’m not one of those shrinks who won’t ever share. But, I’d like to know first why you want to know that.

Jim: I’m not sure. I think I’d like to know that you’ve been there, in the trenches, that you’ve experienced pain like I have.

Dr. Dobrenski: Do you mean that if I’ve taken a psychotropic, it means I’ve felt the same as you?

Jim: Well, yes and no.

Dr. Dobrenski: I think I get it. if I have taken meds, that means that I’ve at least been in some sort of psychological pain, something that warranted medication, like you need right now? It might not mean that we have had the exact same experience, but it’s something relatable?

Jim: Yeah, that sounds good.

Dr. Dobrenski: That sounds good, or that’s accurate?

Jim: Yes, it’s accurate.

Dr. Dobrenski: Okay. Because I want to be clear that no one, whether they’ve taken meds or not, can have been in the same spot as you. Everyone’s pain is different. That’s why I would like to punch other therapists in the face when they say “I know how you feel,” because they don’t. No one can know exactly how you feel.

Jim: Right, but I feel that you at least understand.

Dr. Dobrenski: But you still want to know?

Jim: Yes, I really do.

Dr. Dobrenski: Okay. When I was in graduate school, I got very depressed, for reasons that I don’t really want to get into. But I did take an antidepressant for awhile, and it helped. It wasn’t a cure-all, but it made my life easier to manage, and it helped me to sort things out. My personal experience isn’t why I encouraged you to take your medicine, because we don’t share the same problems, but because I truly believed that it could help you.

Jim: Yeah, I hear that. Should I take an antidepressant as well?

Dr. Dobrenski: Are you depressed?

Jim: No, I just hear a lot of shit that other people don’t. Maybe I need earplugs.

Dr. Dobrenski: But then how will you hear my incessant nagging about your need to take your Haldol?

Jim: Good point, I’ll stick to what the new doctor gives me.

Dr. Dobrenski: You know, there may always be a side benefit of taking medication.

Jim: How so?

As if I hadn’t already wasted enough of Jim’s time with my own self-disclosure, I went on to tell him a story about an exchange on a sweater I tried to make at Banana Republic last Christmas:

Employee: There aren’t any tags on this.

Rob: Right, it’s reversible.

Employee: So?

Rob: It was a gift, and the person took off all the tags, because I would look very stupid wearing a sweater with tags all over one side.

Employee: Why didn’t you try it on before you took the tags off?

Rob: I told you, it was a gift, I didn’t buy it.

Employee: Do you have a receipt?

Rob: No, she didn’t include the receipt in the box.

Employee: How do I know that this is even our shirt?

Rob: Because there is one just like it right behind you. And if it’s a medium, I’d like that one instead, please.

Employee: We can’t track this shirt without a tag.

Rob: So you won’t take it back?

Employee: Right.

Rob: Are you at least sorry?

Employee: Not really.

Rob: I see. Most people apologize when they can’t accommodate a customer.

Employee: Well, I’m not. Do you want to leave the shirt here?

Rob: No, because you’ll just tag it and resell it. I’d rather give it to charity.

Employee: That’s very nice of you.

Rob: Well, I am on medication.

Employee: Really? Like for schizophrenia or something?

Rob: No, an antidepressant.

Employee: Which one?

Rob: How is that relevant to this?

Employee: Hey, you’re the one who connected returning a sweater with his mental health medications.

Rob: Fine, Zoloft.

Employee: Huh…does it make you happy?

Rob: Do I look happy?

Employee: It’s Christmas, no one looks happy.

Rob: True. I suppose Zoloft makes me happier, but I’d still like to return this.

Employee: Tell you what, I’ll give you a gift card for thirty dollars, that will offset some of your loss.

Rob: That’s very generous of you.

Employee: Well, you are on medication.

Jim took in this story with great fascination.

Jim: So do you mean to say that being on meds will help me get free shit, because people will feel sorry for me?

Dr. Dobrenski: No, I’m just saying that anything is possible. If you want, I’ll wear the sweater that I bought next session.

Jim: Sure, that’d be cool. The side effects suck, though.

Dr. Dobrenski: What kind of side effects are you getting?

Jim: Mostly low sex drive.

Dr. Dobrenski: Do you have a partner right now?

Jim: No, I can’t meet any women.

Dr. Dobrenski: Well, if you’re not having sex, why are you concerned about the side effects?

Jim: I guess it’s no big deal right now. But if Angelina Jolie comes knockin’, you and I are gonna have a problem.

Jim: Yeah right, like you know shit about meeting women. You were on friggin’ medication, ya sicko!

So what did we learn? Antipsychotics are potentially very useful medications (despite the side effects), those with severe mental illness sometimes benefit from discretionary self-disclosure and Banana Republic has very poor customer service. That about covers it.

This entry was posted on Tuesday, October 25th, 2011 at 3:49 pm and is filed under Blog. You can follow any responses to this entry through the RSS 2.0 feed.
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I’m just about to commence my masters and phd in clinical psychology and up until now i have suffered from depression/anxiety/bulimia with the occasional night terror. I’ve been considerably stressed about my ability to become a clinician because of the state of my own mental health, but after reading your book i’m feeling much more comfortable. I’m seeing a therapist now, and although i still have some fear about this profession, I feel like I made the right decision in regards to finally getting help.

So thankyou, your insight into the world of a psychologist is truly inspirational 🙂